Revision: Jan. 28, 2025, 3:57 p.m.
HB 691-FN - AS INTRODUCED
2025 SESSION
25-0528
06/09
HOUSE BILL 691-FN
AN ACT prohibiting the addition of fluoridation chemicals to public water systems.
SPONSORS: Rep. Schmidt, Straf. 14; Rep. J. Aron, Sull. 4
COMMITTEE: Resources, Recreation and Development
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ANALYSIS
This bill repeals and prohibits the use of fluoridation chemicals in public water systems.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
25-0528
06/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Five
AN ACT prohibiting the addition of fluoridation chemicals to public water systems.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Fluoride Introduction Prohibited. RSA 485:14 is repealed and reenacted to read as follows:
485:14 Fluoride Introduction Prohibited. No fluoride or any chemical containing fluoride shall be introduced into a public water system.
2 Repeal. The following are repealed:
I. RSA 31:17-a, relative to referendum on public water supply.
II. RSA 44:16, relative to public water supplies.
III. RSA 52:23, relative to public water in village districts.
IV. RSA 485:14-a, relative to referendum for public water systems serving more than one political subdivision.
V. RSA 485:14-b, relative to a fluoride statement.
3 Effective Date. This act shall take effect 60 days after its passage.
25-0528
Revised 1/28/25
HB 691-FN- FISCAL NOTE
AS INTRODUCED
AN ACT prohibiting the addition of fluoridation chemicals to public water systems.
FISCAL IMPACT: This bill does not provide funding, nor does it authorize new positions.
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Estimated State Impact | ||||||
| FY 2025 | FY 2026 | FY 2027 | FY 2028 | ||
Revenue | $0 | $0 | $0 | $0 | ||
Revenue Fund(s) | None | |||||
Expenditures* | $0 | $1,000,000 to $3,000,000 Increase per Fiscal Year | ||||
Funding Source(s) | General Fund | |||||
Appropriations* | $0 | $0 | $0 | $0 | ||
Funding Source(s) | None | |||||
*Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill | ||||||
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Estimated Political Subdivision Impact | ||||||
| FY 2025 | FY 2026 | FY 2027 | FY 2028 | ||
County Revenue | $0 | $0 | $0 | $0 | ||
County Expenditures | $0 | Indeterminable | Indeterminable | Indeterminable | ||
Local Revenue | $0 | $0 | $0 | $0 | ||
Local Expenditures | $0 | Indeterminable | Indeterminable | Indeterminable | ||
METHODOLOGY:
This bill repeals and prohibits the use of fluoridation chemicals in public water systems. The Department of Environmental Services (NHDES) currently receives monthly reports from 11 water systems that fluoridate their water, based on decisions made through local votes. Additionally, 13 other water systems receive fluoridated water from neighboring community water systems, with customers notified that their water may contain fluoride. NHDES reviews these reports to ensure compliance with the fluoride dosage range recommended by the U.S. Centers for Disease Control and Prevention (CDC). The annual cost for NHDES staff to review these reports is estimated to be less than $10,000.
If fluoridation were discontinued, approximately 11 community water systems that purchase fluoride would see a reduction in expenditures. However, the specific financial impact cannot be determined without further analysis and consultation with the affected water systems.
The Department of Health and Human Services (DHHS) projects an additional expenditure of $1,000,000 to $3,000,000 per fiscal year to meet the increased demand for prescription fluoride supplements and other expenses anticipated due to rising cases of tooth decay and cavities, and the subsequent demand for treatment. This expenditure estimate is based on data from June 30, 2024, which indicates that there are 24,749 children ages 0-12 in the Medicaid program residing in 17 communities that have ceased water fluoridation. The average cost of a 30-day supply of prescription fluoride supplements, covered by Medicaid, is $15.37. The estimated total cost per year is in excess of $4.5 million of which federal Medicaid funds covers 50% (24,749 children x $15.37 per 30-day supply = $380,392 + other expenses anticipated as mentioned above * 12 months = $4,500,000+). It is important to note that DHHS stated that the Department does not generally pay for supplements for ages 13+ because it is not recommended.
AGENCIES CONTACTED:
Department of Environmental Services and Department of Health and Human Services